<%@ page language="java" import="java.util.*" pageEncoding="utf-8" %>
<%@ taglib uri="http://java.sun.com/jsp/jstl/core" prefix="c" %>
<%
    String path = request.getContextPath();
    String basePath = request.getScheme() + "://" + request.getServerName() + ":" + request.getServerPort() + path + "/";
%>
<%@ taglib prefix="fmt" uri="http://java.sun.com/jsp/jstl/fmt" %>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
<head>
    <base href="<%=basePath%>">
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8"/>
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport"
          content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=no"/>
    <meta name="renderer" content="webkit">
    <link rel="stylesheet" type="text/css" href="css/styles.css">
    <link rel="stylesheet" type="text/css" href="css/admin.css">

    <script type="text/javascript" src="js/jquery-1.4.4.min.js"></script>
    <script type="text/javascript" src="js/admin.js"></script>
    <script type="text/javascript">
        $(document).ready(function () {
            //重新绑定表单提交
            $("#add_btn").bind("click", function () {
                $('form').submit();
            });

        });
    </script>

</head>

<body>
<div class="panel admin-panel">
    <div class="panel-head" id="add"><strong><span class="icon-pencil-square-o"></span>添加家庭档案信息</strong></div>
    <div class="body-content">
        <form id="form-addrole" method="post" class="form-x" action="<%=path%>/familyadd">
            <input id="fid" name="fid" value="" type="hidden"/>
            <div class="form-group">
                <div class="label">
                    <label>县级编号：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="countyId" data-validate=" required:请输入县级编号"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>乡镇编号：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="countryId" data-validate=" required:请输入乡镇编号"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>村编号：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="villageId" data-validate=" required:请输入村编号"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>组编号：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="groupId" data-validate=" required:请输入组编号"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>家庭编号：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="familyId" data-validate=" required:请输入家庭编号"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>户主：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="familyName" data-validate=" required:请输入户主"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>身份证号：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="identityCard"
                           data-validate=" required:请输入身份证号"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>性别：</label>
                </div>
                <select name="sex" class="input "
                        style="width:250px; line-height:17px;display:inline-block;float: left">
                    <option value="男">男</option>
                    <option value="女"> 女</option>
                </select>
                <%-- <div class="field">
                     <input type="text" class="input w50" value="" name="sex" data-validate=" required:请输入性别" />
                     <div class="tips"></div>
                 </div>--%>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>出生日期：</label>
                </div>
                <div class="field">
                    <input type="date" class="input w50" value="" name="birthday" data-validate=" required:请输入出生日期"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>民族：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="nation" data-validate=" required:请输入民族"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>健康状况：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="health" data-validate=" required:请输入健康状况"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>文化程度：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="culture" data-validate=" required:请输入文化程度"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>人员属性：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="personnerAttributes"
                           data-validate=" required:请输入人员属性"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>是否农业户口：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="attribute" data-validate=" required:请输入是否农业户口"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>婚姻状况：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="maritalStatus"
                           data-validate=" required:请输入婚姻状况"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>工作单位：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="workUnit" data-validate=" required:请输入工作单位"/>
                    <div class="tips"></div>
                </div>
            </div>

            <div class="form-group">
                <div class="label">
                    <label>联系电话：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="telephone" data-validate=" required:请输入联系电话"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>家庭人口数：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="familyNumber"
                           data-validate=" required:请输入家庭人口数"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>农业人口数：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="agricultureNumber"
                           data-validate=" required:请输入农业人口数"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>家庭住址：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="" name="familyAddress"
                           data-validate=" required:请输入家庭住址"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label>登记员：</label>
                </div>
                <div class="field">
                    <input type="text" class="input w50" value="${sysUser.userName}" name="registerName" data-validate=" required:请输入登记员"/>
                    <div class="tips"></div>
                </div>
            </div>
            <div class="form-group">
                <div class="label">
                    <label></label>
                </div>
                <div class="field">
                    <button id="add_btn" class="button bg-main icon-check-square-o" type="button"> 提交</button>
                </div>
            </div>


        </form>
    </div>
</div>

</body>
</html>
